Nepal

8.2 HIV TESTING AND COUNSELING
HIV testing and counseling is one of the essential interventions in HIV prevention and care. It both
promotes the prevention of HIV infection and is an entry point to care and support, including ART. The
government of Nepal recognizes the importance of and seeks to promote HIV testing and counseling. The
goal is to enable 90 percent of people living with HIV to know their HIV status and, thus, to have timely
access to the care, support, and treatment services necessary to prevent the spread of HIV infection and
improve the quality of life of those already infected. Although there has been good progress toward that goal,
according to NCASC estimates, 33 percent of people with HIV remain unaware of their HIV status (NCASC,
2016c).
8.2.1 Service Availability
In the public health sector, HIV testing and counseling services are mainly available in hospitals
and primary health care centers (PHCCs). However, testing and counseling also may be available in some
health posts (HPs) where prevention of mother-to-child transmission (PMTCT) services are provided as part
of antenatal care and/or delivery care. Therefore, the 2015 NHFS gathered information from all types of
health facilities, namely public hospitals, private hospitals, PHCCs, HPs, and urban health centers (UHCs).
Similarly, stand alone HTCs was also chosen to gather the information. In all facilities, information
pertaining to testing and counseling was collected from the primary location where these services are offered.
The results showed that 86 percent of zonal and above hospitals, 69 percent of stand-alone HIV
testing and counseling sites (HTCs), and 57 percent of district-level hospitals had an HIV testing system, as
compared with 25 percent of private hospitals and 11 percent of PHCCs (Table 8.1 and Figure 8.1). As
expected, an HIV testing system was available in only a limited number of HPs and no UHCs. Because HPs
constitute a large majority of the health facilities in Nepal, overall, only 6 percent of health facilities in the
country have an HIV testing system. By region, the availability of HIV testing systems ranges from 2 percent
of facilities in the mountain region to 8 percent in the terai region. In earthquake-affected districts, 7 percent
of facilities have an HIV testing system in place.
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